Uehara Hiroki, Oe Yutaro, Yoshimura Takaki, Gunji Takahiro, Okuyama Masaki
Cardiovascular Medicine, Kin-ikyo Chuo Hospital, Sapporo, JPN.
Cureus. 2024 Feb 5;16(2):e53608. doi: 10.7759/cureus.53608. eCollection 2024 Feb.
Campylobacter spp. is a widely recognized pathogen accountable for acute enteritis, frequently linked to sepsis, primarily attributed to C. jejuni. Instances of Campylobacter-induced cholecystitis are infrequent, with only a limited number of documented case reports. Acute cholecystitis has been sporadically documented to induce electrocardiographic alterations, occasionally simulating an acute coronary syndrome (ACS). Herein, we present an instance of cholecystitis induced by C. jejuni, posing a challenge in its differentiation from ACS due to electrocardiographic modifications. An 85-year-old Japanese male presented to our hospital with a complaint of chest discomfort lasting one hour. His medical history included hypertension, dyslipidemia, and effort angina pectoris, with a prior percutaneous coronary intervention. The chest discomfort, accompanied by pain and pressure, raised uncertainty about its similarity to a previous angina episode. Vital signs were in the normal range. Physical examination revealed no abnormal heart or lung sounds. Electrocardiography indicated a right bundle branch block and new ST-segment elevation in V2-3. Echocardiography, chest X-rays, and blood tests showed no abnormalities. Emergency coronary angiography revealed no stenosis. Post-angiography, chest discomfort persisted, and the patient developed fever and chills. Contrast-enhanced CT revealed gallbladder lithiasis, prompting suspicion of sepsis. C. jejuni was detected, and antimicrobial therapy resolved symptoms.
弯曲杆菌属是一种广为人知的病原体,可导致急性肠炎,常与败血症相关,主要归因于空肠弯曲菌。弯曲杆菌引起胆囊炎的病例很少见,仅有有限数量的病例报告。急性胆囊炎偶尔会引起心电图改变,有时类似于急性冠状动脉综合征(ACS)。在此,我们报告一例空肠弯曲菌引起的胆囊炎病例,因其心电图改变,在与ACS鉴别诊断方面存在挑战。一名85岁的日本男性因胸部不适持续1小时前来我院就诊。他的病史包括高血压、血脂异常和劳力性心绞痛,曾接受经皮冠状动脉介入治疗。胸部不适伴有疼痛和压迫感,这使其与既往心绞痛发作的相似性存在疑问。生命体征在正常范围内。体格检查未发现心脏或肺部异常声音。心电图显示右束支传导阻滞,V2 - 3导联出现新的ST段抬高。超声心动图、胸部X线和血液检查均未发现异常。急诊冠状动脉造影未发现狭窄。造影术后,胸部不适持续存在,患者出现发热和寒战。增强CT显示胆囊结石,提示败血症。检测到空肠弯曲菌,抗菌治疗后症状缓解。